Thursday, April 30, 2009

Why I Am Against the Marketing of Formula Milk

Whilst individual mothers fight their own battles to establish breastfeeding in the face of familial and societal disapproval, international organisations are fighting to preserve the practice of breastfeeding across the world. After reading about the illegal Cow&Gate advert I researched a little more about the formula marketing regulations that the UK government is supposed to enforce. Here is the situation as I understand it.

There is a set of guidelines on marketing of formula called the International Code of Marketing of Breastmilk Substitutes. This code was prepared by the World Health Organisation (WHO) and the United Nations Childrens Fund (UNICEF). It was adopted by the World Health Assembly (WHA) in 1981 as a "minimum requirement" to protect infant health and is intended to be implemented in its entirety. The World Health Assembly is the forum by which the WHO is governed, and comprises the Ministers of Health of the worlds governments, their advisers, and eminent experts in the field of public health. The US originally voted against the code, but in 1994 it was endorsed by Bill Clinton's government so in theory, every member of the WHO supports the code. This information can be found in more detailed form by clicking here.

The International Baby Food Action Network summarises the code as "an international public health recommendation to regulate the marketing of breastmilk substitutes". The code is not binding like a treaty, but implementation of the code is seen as necessary under the UN Convention on the Rights of the Child. Full details of the code can be found here.

In 2008 the UN Committee on the Rights of the Child considered the UK's implementation of the code and reported:
The Committee, while appreciating the progress made in recent years in the promotion and support of breastfeeding in the State party, it is concerned that implementation of the International Code of Marketing of Breastmilk Substitutes continues to be inadequate and that aggressive promotion of breastmilk substitutes remains common.

The Committee recommends that the State party implement fully the International Code of Marketing of Breastmilk Substitutes. The State party should also further promote baby-friendly hospitals and encourage that breastfeeding is included in nursery training.

So "aggressive promotion of breastmilk substitutes remains common" in the UK at the moment. Why is this a problem? We all know that once a mother makes the decision to feed formula milk, it is very difficult to revert back to breastfeeding, even if that is what she would like to do. So the decision to give formula milk should really be made with full knowledge of the advantages and disadvantages of using breastmilk substitutes. This is the problem, and the reason that I object to the marketing of formula milk: it is inevitably one-sided, proclaiming the advantages of formula milk without alluding to the fact that breastmilk is better for babies. Information on infant feeding needs to be presented in a balanced, factual manner so that women are informed but not seduced. If, when armed with the necessary knowledge, they choose to formula feed then that is their own decision. But formula milk advertising will never be balanced and factual and therefore it should not be allowed.

I find the current situation, in which advertising of follow-on milk is lawful, to be ridiculous. As the Baby Feeding Law Group points out, companies easily exploit this loophole by branding their follow-on milk products in a virtually identical way to their basic breastmilk substitutes. They also provide websites and operate baby clubs in order to present themselves as authorities on infant care and nutrition. Information on infant nutrition will never be unbiased when it is provided by a company wishing to sell its own products.

The battle to convince more women to breastfeed will not be won as a result of any state legislation or government action. The advice of family and friends is probably more influential than any breastfeeding awareness campaign could be. But formula milk advertisements cannot help any mother to make an informed choice on her feeding method. If an advert is responsible for just one baby growing up less healthily as a result of being formula fed, then that is one baby too many. So I wish that the UK government would start to properly enforce the International Code of Marketing of Breastmilk Substitutes, and perhaps one day progress to a total ban on formula milk advertising.


Baby Milk Action press release
World Health Assembly wikipedia page
International Baby Food Action Network page on International Code of Marketing of Breastmilk Substitutes
Baby Feeding Law Group


docwitch said...

I've noticed the follow-on milk advertising. And yes, it is aggressive and there is virtually no immediate visual distinction between these and the breastmilk subs.

I had to use formula to supplement my breast milk, because due to a long-term health issue, I never made enough of my own milk to exclusively feed my baby, and I was always quite stunned and dismayed that it was pretty much a given in the wider culture, and with a number of people that I encountered that "sure 'breast is best', but formula's so convenient, and most of them are as good as breast milk these days", (??) And the advertisers bang on about all these Omega 3's that are being added to make your child 'smart'. The subtext with all the marketing is that it's as good as breast milk.

I would have given my eye teeth to ditch the formula completely. I got over not being able to have a natural birth pretty quickly. But having to resort to formula to keep my child alive was a huge disappointment. The decision to give a baby formula should be seen as a very serious decision, and one not to be made lightly. Not a question of convenience. Most women I know feel this way too.

Thanks for your excellent post.

clareybabble said...

Hi I just clicked through to this from British Mummy Bloggers :)

I couldn't agree with you more! Every time I see those follow on milk adverts it makes me sick. You have an even happier and healthier baby with breastmilk and if it's not meant to substitute breastmilk then what is it for?!

They scare you by saying your baby won't get enough iron, etc so more Mums end up giving up the breastfeeding for fear of having a malnourished baby.

Sorry to rant but it's a subject close to my heart!

Clare xx

Jessica - This Is Worthwhile said...

Really interesting stuff. I wonder what a balanced advertisement would even look like. The whole point is to sway a potential customer so of course the ads are going to be biased, half-truths, etc. It might be better to not allow advertising at all anymore.

I'm not comparing formula to tobacco, but look at what governing bodies have done to tobacco companies' abilities to advertise. Here in the States they can't advertise whatsoever and even have to commit large sums of money to tobacco education. The consumers who want a cigarette still buy it.

The flip side to all of this is that if formula's ugly side is to be truly aired out to the public, then there also has to be a shift in the thoughts on breastfeeding, i.e., a lot more support for the mother (longer mat leave, more social acceptance, less stigma if she chooses not to, more breastfeeding education, etc).

Just a thought...

Cave Mother said...

Just an observation that I didn't include in the post: the ONLY entertainment TV show that I have seen that even mentions breastfeeding is Family Guy! Stewie the baby breastfeeds. There was one funny bit where he latched on to his dad's nipple too :) If breastfeeding was all around us, on billboards, on TV shows, in magazines, then it would become much more socially acceptable. Think about how much more acceptable nudity on TV has become (at least here in the UK). The same could be done for breastfeeding, if it was encouraged.

amy said...

Having brought all my four up on formula milk i think the sentence 'If an advert is responsible for just one baby growing up less healthily as a result of being formula fed, then that is one baby too many.' is a bit harsh.

my babies are not 'less healthy' than others who were breast fed. I agree that adverts should not persuade mothers to formula feed but highlighting the advavntages of follow on milk to a formula feeding mother is not a bad thing. my 18 month old has follow on milk unlike my other 2 older girls and she gets less colds and illnesses than them.

We all know 'breast is best' but i know many mothers who have suffered from PND because of the pressure to breast feed and feeling like a failure due to ugly anti formula groups of people. Breast may be best but is it best when it comes with suffering from the mother? nice post x x

Cave Mother said...

Hi Amy. I agree that it is OK to highlight the advantages of follow on milk to mothers who are already formula feeding, but I don't know how this would be accomplished without also giving a message to other mothers. The medical evidence says that babies fed on artificial breastmilk substitutes on average get more minor illnesses like colds and flu than breastfed babies. So it seems fair to say that, on average, formula fed babies are "less healthy". But of course this is an average, so some formula fed babies will get few colds and some will get more. Maybe you are fortunate to have a baby who has strong immunity.

Anyway, thanks for commenting :)

Amanda said...

By-the-way...That is one of the best breastfeeding photos. I tried over and over to get that shot when Rowan was a little bean, but neither he nor my breast ever cooperated!

Cave Mother said...

Amanda - you have inspired me to try and get a picture of my baby feeding like that. This is just a standard picture I nicked off some site. Before I breastfed, I would have found shots like this a bit weird. But now I think they are SO beautiful.

Perfectly Happy Mum said...

To the breastfeeding mums, think of this one: how about mums who CANNOT for any reason breast feed their babies? Should they just be left in a corner and not given any advice or information at all?
I had a breast reduction when I was 19 and as a result of this was unable to breastfeed. I was aware of the consequences of the breast reduction, but decided to go through with it because the pain and nearly depressive state I was going through, because of the size of my breasts, was far too much to cope with. Yes I made the decision then to go ahead and realised that I would probably have to formula feed my children. When I found out I was pregnant for the first time, I looked EVERYWHERE possible for some info on formula and what was I supposed to look for to make the right choice. Not ONE person from the medical staff agreed to guide me a little.
I took an antenatal class with NCT and the last class was on feeding... or they should have said strictly breastfeeding class. It resulted in making feel awkward and selfish. I gave birth to my baby feeling bad then you know what I stood up and said F***K it, I am a formula feeding mum and my babies are strong healthy boys and I am proud to give them the best gift of all, the one made of love, patience and tenderness.
I am not saying breast is not best, what I am saying is that marketing might be a bit pushy or wrong in your eyes, but trust me in my eyes there it is truly lacking.
Hope you can see the world wearing my shoes a little bit and I definitely agree that you should be proud of yourself, you are doing a great job, but mums who do not breast feed do a great job too you know.

Cave Mother said...

That's an interesting viewpoint, PHM. Actually the organisation Baby Milk Action campaigns for good info to be available on formula feeding, as well as breastfeeding. Their website says:

Protecting babies fed on formula

Breastmilk substitutes are legitimate products for when a child is not breastfed and does not have access to expressed or donor breastmilk. Companies should comply with composition and labelling requirements and other Code requirements to reduce risks - independently of government measures. Parents have a right to accurate, independent information.

Baby Milk Action is not anti-baby milk. Our work protects all mothers and infants from irresponsible marketing.
I think there is a link to their site on the original post.

It must be difficult when for medical reasons you have to give formula food. And that is why we do need formula milk to be available - but you would have used it whether or not it was advertised. A company trying to sell a product will never be a good source of accurate, impartial information on anything. So if more information is needed on formula feeding, advertising is certainly not the route through which it should be provided.

Mum Like said...

Not all mums can do breastfeeding, that's whay they turn to formula milk good for babies. But I think companies must also present the benefits of breastfeeding and not all out formula side only.